14.hanau's quint

14. Hanau’s Quint14. Hanau’s Quint

Michael Hamada DDSMichael Hamada DDSDivision of Advanced Prosthodontics, Biomaterials Division of Advanced Prosthodontics, Biomaterials

and Hospital Dentistryand Hospital Dentistry

UCLA School of DentistryUCLA School of Dentistry

This program of instruction is protected by copyright ©. No portion of this This program of instruction is protected by copyright ©. No portion of this program of instruction may be reproduced, recorded or transferred by program of instruction may be reproduced, recorded or transferred by any means electronic, digital, photographic, mechanical etc., or by any any means electronic, digital, photographic, mechanical etc., or by any information storage or retrieval system, without prior permission.information storage or retrieval system, without prior permission.

Hanau’s QuintHanau’s Quint

Five Factors Affecting Occlusal BalanceFive Factors Affecting Occlusal Balance– Condylar InclinationCondylar Inclination– Incisal GuidanceIncisal Guidance– Occlusal Plane InclinationOcclusal Plane Inclination– Compensating CurveCompensating Curve– Cuspal InclinationCuspal Inclination

Hanau’s QuintHanau’s Quint

Inter-relationship of these five factors may be Inter-relationship of these five factors may be described bydescribed by Theilman’s Formula Theilman’s FormulaIn order to maintain a balanced occlusion:In order to maintain a balanced occlusion:

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

C=Balanced Occlusion

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

When all five factors are in “balance” . . .

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

. . .“Balance” is maintained in excursives

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

When Incisal Guidance is increased . . .

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

When Incisal Guidance is increased . . .

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

. . . Posterior Disclusion will occur unless . . .

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

. . . Occlusal Plane Inclination, . . .

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

. . . Cuspal Inclination, . . .

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

. . . or Compensating Curve is Increased

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Increasing the Compensating Curve

Correcting Posterior Disclusion by

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Use of Flat Plane or 0º Posteriors

Monoplane Denture Occlusion

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Use of Flat Plane or 0º Posteriors

Monoplane Denture Occlusion

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Use of Flat Plane or 0º Posteriors

Monoplane Denture Occlusion

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Posterior Disclusion with 0º Teeth

Monoplane Denture Occlusion

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Posterior Disclusion with 0º Teeth

May be corrected by “Balancing Ramps”

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Posterior Disclusion with 0º Teeth

Essentially increases Compensating Curve

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Posterior Disclusion with 0º Teeth

Alternate solution to maintaining “balance”. . .

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Posterior Disclusion with 0º Teeth

. . . is to decrease Incisal Guidance

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Posterior Disclusion with 0º Teeth

. . . is to decrease Incisal Guidance

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Posterior Disclusion with 0º Teeth

. . . is to decrease Incisal Guidance

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Posterior Disclusion with 0º Teeth

. . . is to decrease Incisal Guidance

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Posterior Disclusion with 0º Teeth

is minimized by minimizing Incisal Guidance

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

The minimal disclusion can be corrected by

Balancing Ramp Addition (as before) or . . .

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

The minimal disclusion can be corrected by

. . . an increase in Occlusal Plane Inclination

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

The minimal disclusion can be corrected by

. . . an increase in Occlusal Plane Inclination

Hanau’s QuintHanau’s Quint

Of the five factors, the patient presents you with Condylar Inclination

Occlusal Plane cannot be altered substantially since functional requirements dictate position

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Hanau’s QuintHanau’s Quint

Of the five factors, the patient presents you with Condylar Inclination

Occlusal Plane cannot be altered substantially since functional requirements dictate position

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Hanau’s QuintHanau’s Quint

Within the confines of esthetics and phonetics, minimize Incisal Guidance in Complete Dentures to minimize inclined tipping forces

Adjust remaining factors to maintain balance

C=Condylar Inclination

OccPlane

x Incisal Guidance

x Cuspal Inclination x CompCurve

Bilateral Balanced Lingualized OcclusionBilateral Balanced Lingualized Occlusion

Working SideWorking Side

Centric OcclusionCentric Occlusion ProtrusiveProtrusive

Balancing SideBalancing Side